Systematic Analysis of Extracting Data on Advance Directives from Patient Electronic Health Records (EHR) in Terminal Oncology Patients

• DOI: 10.1177/08258597211001153
• Publication Date: 2021-03-12T22:11:56Z
• Authors: Jason S. Starr; William Paul Skelton; Kiarash P. Rahmanian; Robert Guenther; William L. Allen; Thomas J. George; Ray E. Moseley
• Keywords: Power of attorney; Terminal cancer; Advance Care Planning; Living Wills; Directive; Terminally ill

Advance directives are legal documents that include living wills and durable health care power of attorney documents. They critical components for seriously ill patients which designed to be implemented when a patient is terminally incapacitated. We sought evaluate potential reasons why advance were not appropriately implemented, by reviewing the electronic record (EHR) in with terminal cancer.A retrospective analysis EHR 500 cancer from 1/1/2013 12/31/2016 was performed. Data points manually collected entered central database.Of patients, 160 (32%) had an directive (AD). The most common clinical terminology used physicians indicating diagnosis progressive (36.6%) palliative (31%). incapacity altered mental status (25.6%), oriented (14%). 34 (6.8%) met all criteria having diagnosis, documented AD, deemed Of these who data points, their ADs on average 1.7 days (SD: 4.4 days) after they should have been. This resulted total 58 additional provided.This study provided insight how managed day practice hospital. From our it appears able identify terminal, however, typically later than been recognized. Further studies performed focusing harnessing providing formative evaluative feedback patterns ensure honored appropriate.